42660 Dilation and catheterization of salivary duct, with or without injection

Name of the Procedure:

Dilation and Catheterization of Salivary Duct, with or without Injection
Common Names: Salivary Duct Dilation, Salivary Duct Catheterization
Medical Term: Sialodochoplasty

Summary

Dilation and catheterization of the salivary duct is a procedure to widen the ducts that drain saliva from the glands in your mouth. A catheter or a small tube is inserted into the ducts to help them open up, sometimes involving the injection of fluids to clear any blockages.

Purpose

This procedure is mainly used to treat obstructions or narrowing of the salivary ducts, which can cause pain, swelling, or chronic infections. The goal is to restore proper saliva flow, reduce symptoms, and prevent recurrent infections.

Indications

• Chronic swelling and pain in the salivary glands
• Recurrent infections or sialadenitis (inflammation of the salivary gland)
• Presence of stones or strictures within the salivary ducts
• Difficulty eating or dry mouth due to blocked ducts

Preparation

• Fasting for a few hours before the procedure may be required.
• Review of current medications; you might need to stop certain blood thinners or anti-inflammatory drugs.
• Diagnostic imaging (e.g., ultrasound, sialography) to evaluate the duct structure.

Procedure Description

1. The procedure typically starts with the administration of a local anesthetic to numb the area.
2. A small, flexible catheter is inserted into the duct through the natural opening in the mouth.
3. The catheter is gently advanced to dilate (widen) the duct.
4. If needed, a saline solution or other fluid may be injected to help clear any blockages.
5. The catheter may be temporarily left in place to maintain the duct opening.
6. The area is monitored for immediate complications before discharge.

Duration

The procedure usually takes between 30 minutes to an hour.

Setting

This procedure is typically performed in an outpatient clinic, hospital, or surgical center.

Personnel

• Otolaryngologist (ENT specialist) or Oral and Maxillofacial Surgeon
• Nurses or medical assistants
• An anesthesiologist, if sedation is used

Risks and Complications

• Infection
• Bleeding
• Pain or discomfort
• Risk of ductal injury or perforation
• Temporary swelling or bruising

Benefits

• Improved saliva flow
• Reduction in gland pain and swelling
• Decreased frequency of infections
• Improved quality of life

Recovery

• After the procedure, patients may experience mild pain or swelling.
• Over-the-counter pain relievers and ice packs can help manage discomfort.
• Follow-up appointments are necessary to monitor the healing process and duct function.
• Patients may need to follow a soft food diet and practice good oral hygiene to prevent infection.

Alternatives

• Conservative management with medications and massage
• Sialendoscopy (minimally invasive endoscopic procedure)
• Surgery to remove the affected gland
• Each option has its own risks and benefits, which should be discussed with your healthcare provider.

Patient Experience

During the procedure, patients might feel some pressure or mild discomfort but usually not pain due to the local anesthetic. Post-procedure discomfort is typically mild and can be managed with pain medication. It’s normal to experience some swelling or tenderness for a few days. Pain management and comfort measures, such as ice packs and over-the-counter pain relievers, can assist in recovery.